Health and Social Care
Steve Barclay Excerpts(1 year ago)
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Theo Clarke
What steps are the Government taking to increase the recruitment of midwives, given the closure of Stafford County Hospital’s freestanding midwifery birthing unit due to shortages, and how is the Secretary of State going to ensure that all midwives are trained to deal with birth injuries to reduce risk?
Steve Barclay
My hon. Friend raises an important point, and I know she has secured a debate in the House this week to further explore these issues. She will be aware that there has been a 13% increase in the number of midwifery programme place starters since two years ago. That is alongside the £165 million added to the maternity budget since 2021 and the key increase in midwifery places in the long-term workforce plan.
[Official Report, 17 October 2023, Vol. 738, c. 145.]
Letter of correction from the Secretary of State for Health and Social Care, the right hon. Member for North East Cambridgeshire (Steve Barclay):
An error has been identified in my response to my hon. Friend the Member for Stafford (Theo Clarke). The correct response should have been:
Steve Barclay
My hon. Friend raises an important point, and I know she has secured a debate in the House this week to further explore these issues. She will be aware that the long-term workforce plan anticipates a 13% increase in the number of midwifery programme place starters since two years ago. That is alongside the £165 million added to the maternity budget since 2021 and the key increase in midwifery places in the long-term workforce plan.
Oral Answers to Questions
Steve Barclay Excerpts(1 year, 8 months ago)
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Jeff Smith (Manchester, Withington) (Lab)
The Secretary of State for Health and Social Care (Steve Barclay)
We are investing an additional £2.3 billion a year by 2023-24 so that 2 million more people can access NHS-funded mental health support.
Rachel Hopkins
Research by the Royal College of Psychiatrists shows that between July 2021 and July 2022, referrals to child and adolescent mental health services increased by 24%. Labour has set out a fully costed plan to recruit 8,500 new staff. Why have the Government failed to produce their own plan to recruit more mental health staff to reduce waiting times?
Steve Barclay
We are recruiting more mental health workers, with 7,400 more full-time equivalents in September 2022 compared with September 2021. That reflects the significant additional funding we are providing—the extra £2.3 billion going in by 2023-24.
Jeff Smith
Perinatal mental health problems affect one in four new or expectant mothers, and 40% of deaths in the first year after pregnancy are related to mental health. What steps are the Government taking to improve support for women with perinatal mental health needs, particularly in the light of the women’s health strategy?
Steve Barclay
The hon. Gentleman raises an extremely important subject. As well as the additional investment and extra workforce we are putting into mental health, we are looking at this issue as part of our strategies in other areas—for example, our suicide strategy—and examining our capital investment. There is a range of measures to address this very important issue.
Crispin Blunt (Reigate) (Con)
My right hon. Friend is aware of the evidence on the use of psychedelic drugs for more effective mental health care. Last month Australia, having assessed the evidence on psilocybin, started the rescheduling process, and Australians suffering from depression will be able to access this medicine from July. In the USA, the Food and Drug Administration has recognised psilocybin as a breakthrough therapy for depression. In Canada, the special access programme allows physicians to request a licence for assisted therapy under certain conditions. Our drug laws remain based on a 50-year-old, unevidenced, prejudiced assessment and nothing else. The Home Office has never commissioned evidence on psilocybin. Does my right hon. Friend understand that this is a primary public health issue, on which he should lead?
Steve Barclay
I recognise the close interest my hon. Friend takes in this matter, and he is right to draw the House’s attention to international best practice. I agree that we should take an evidence-based approach in which we look at the data shared with regulators in other countries, such as Australia. I am happy to draw the point he makes to the attention of our regulators.
Kelly Tolhurst (Rochester and Strood) (Con)
Anorexia affects many young people. One of my constituents had to give up work to look after her daughter, who was diagnosed with anorexia nervosa and made a number of attempts to overdose—the latest just two weeks ago. The daughter is also suspected to be suffering from an obsessive compulsive disorder and an autism spectrum disorder, but has been told that the wait for diagnosis is over two years. Will my right hon. Friend outline what support we can give my constituent and her family? Have we thought about providing personal budgets, so that if the NHS is unable to treat an individual, they can seek treatment outside the NHS?
Steve Barclay
My right hon. Friend raises an important issue, and I am happy to look into the individual case she describes. Our wider objective in providing extra funding is to ensure that we treat more people, with 2 million more people accessing NHS-funded mental health support by 2023-24 and the number of patients in talking therapies last year up by a fifth from the year before.
Dr Rosena Allin-Khan (Tooting) (Lab)
There is a mental health staffing crisis of the Government’s own making. Figures out last week show that there are more than 28,000 mental health vacancies in our NHS, which is up on the year before and the year before that. Are we seeing a pattern here? The number of mental health nurses is down 5% since 2010, but do not worry, Mr Speaker: just so the Secretary of State is aware, Labour has a plan to recruit and retain more mental health staff and to get waiting times down. Can he put a word in with the Chancellor in case he wants to nick that too?
Steve Barclay
It is always good to find a plan that the hon. Lady actually agrees with the shadow Health Secretary on. As we know from her questions, that is not always the case, not least on the use of the independent sector. What we do know is that she has a habit of writing her questions before she hears the previous answer. I just reminded the House of the 7,400 more staff in mental health in September 2022 compared with September 2021. Obviously she had written her question before that point.
John Stevenson (Carlisle) (Con)
The Secretary of State for Health and Social Care (Steve Barclay)
We have opened five new medical schools in Sunderland, Lancashire, Chelmsford, Lincoln and Canterbury as part of our wider drive to increase the number of doctors.
John Stevenson
Does the Secretary of State agree, first, that we must train enough of our own doctors, rather than depend on overseas doctors? Secondly, does he agree that it is important that the less traditional educational institutions are allowed to open or expand medical schools, as they are often in areas where doctors are in short supply?
Steve Barclay
I agree with my hon. Friend, and that is why we had a 25% increase in the total number of medical school places. On the specific point he raises, we have developed the new apprenticeship route for medical doctors so that we can start to have more training through that route and not just through the undergraduate route.
Valerie Vaz (Walsall South) (Lab)
As well as recruiting doctors, how do we retain doctors? A doctor in my constituency says that at the end of the day he takes home £100 a week. That is less than a decorator. What are the Government doing about retaining good doctors like my constituent?
Steve Barclay
It is worth pointing out to the House that the vacancy rate for doctors has fallen compared with where it was before the pandemic. That is often not the narrative that is put out there, but the right hon. Lady is right to highlight the importance of retention. It is obviously better to retain a doctor, given the cost and time it takes to recruit, and that is about looking at a combination of pay issues, about which we are talking to trade union colleagues, and non-pay issues, which are often a real factor in the quality of work that doctors are doing and often shapes retention issues.
Wes Streeting (Ilford North) (Lab)
I am afraid that talk is cheap. I was at Worcester University’s medical school yesterday, where I was told directly by the vice-chancellor that that university, which has great facilities, can only recruit international students because the Government will not fund places for domestic students. The NHS has asked for medical school places to be doubled. Labour has a plan to double medical school places, paid for by abolishing the non-dom tax status. Why do the Government not swallow their pride and adopt Labour’s plan in next week’s Budget?
Steve Barclay
First, as I said a moment ago, we are funding a 25% increase in medical undergraduate places, and we have given a commitment to a workforce plan, as the Chancellor set out in the autumn statement. The question that the shadow Secretary of State should address is his party’s opposition to international recruitment. We have more than 45,000 doctors who have been recruited internationally, yet the Leader of the Opposition says he wants to move away from international recruitment, which is an important source of additional doctors.
Mary Glindon (North Tyneside) (Lab)
Mrs Emma Lewell-Buck (South Shields) (Lab)
The Secretary of State for Health and Social Care (Steve Barclay)
The Government are committed to building 40 new hospitals, which is why we have confirmed an initial £3.7 billion for the first four years of the new hospital programme.
David Simmonds
One of those 40 new hospitals is Hillingdon Hospital. At the start of this year, Hillingdon Council granted planning consent for the proposed new hospital, which is much awaited by my constituents. Will my right hon. Friend tell me when we might expect building work to commence?
Steve Barclay
As my hon. Friend knows, I have been to Hillingdon to look at the scheme. I am aware of how essential it is to his local area. He will know that on 22 February, the Prime Minister spoke at Prime Minister’s questions of the Government’s commitment to building 40 new hospitals, and I hope to announce something on that very shortly.
Afzal Khan
The conditions at North Manchester General Hospital continue to worsen. Last month, theatres were forced to close for six weeks following a ceiling collapse. It is four years since the Government announced the rebuild under the new hospital programme, but little progress has been made. In January, the leader of Manchester City Council wrote to the Secretary of State offering to host a meeting to discuss the project. Will he commit to accepting the invitation?
Steve Barclay
I or another member of the ministerial team will, of course, meet the leader of Manchester council to discuss this. We are making progress. The hon. Gentleman will have seen progress, for example, at the Royal Liverpool and the Northern Centre for Cancer Care, but I confirm our commitment to the 40 hospitals programme and hope to say more on that shortly.
Mrs Lewell-Buck
I heard the responses from the Secretary of State, and it must be really hard for him to keep up the pretence about these mythical hospitals. Here is the reality of what is happening in hospitals around the country. South Tyneside District Hospital was award winning. Despite widespread opposition from all of us at the Save South Tyneside Hospital campaign, we have seen a loss of key services and a downgrading of other services. Despite the work of the amazing staff, the hospital now requires improvement. Why is his Government forcing that decline?
Steve Barclay
The Government have committed an initial £3.7 billion, which indicates our commitment to the new hospital programme. As I said, I will have more to say on that shortly.
Mr Peter Bone (Wellingborough) (Con)
Kettering General Hospital serves my constituency, and work has already started on building a new hospital—one of the Boris hospitals—so I do not know what all the fuss is about. The Government are getting on and doing the job. Is that correct?
Steve Barclay
It is. As my hon. Friend will know from another of my visits, which was with him to Kettering, the enabling works are progressing. That is in no small part a tribute to the work that he and neighbouring MPs have done to strongly make the case for Kettering. I know that he will continue to do so, and I look forward to working with him on that.
Dr Rupa Huq (Ealing Central and Acton) (Lab)
Sarah Atherton (Wrexham) (Con)
The Secretary of State for Health and Social Care (Steve Barclay)
We published the urgent and emergency care recovery plan, which set out a number of measures to improve patient flow within hospitals, which has an impact on ambulance performance. In addition, we are purchasing 800 new ambulances, which will be on the road this year.
Antony Higginbotham
The Secretary of State will be aware that, in 2007, the last Labour Government closed the accident and emergency at Burnley General Teaching Hospital. When I speak to my constituents about ambulance wait times, the one thing that they always return to is bringing back the A&E at Burnley, which the Labour Government took away. I have raised this issue with Health Ministers since the day I was elected, so will he set out whether it will ever be possible to bring back the A&E that Labour closed? Will he meet me to discuss it?
Steve Barclay
My hon. Friend is right to highlight the consequences of closures such as that, PFI or other issues that are still felt in communities such as Burnley. He will also know that it is for the integrated care board to look at commissioning decisions and I know that he will make his case powerfully to that board.
Sarah Atherton
The Welsh Labour Government have a service level agreement with the Welsh ambulance service to hand over patients to hospital within 15 minutes. At the Wrexham Maelor Hospital, this target is consistently missed, and a recent handover took eight hours 36 minutes. Does the Secretary of State agree that the Welsh Government need to stop playing the blame game and start working in partnership for the betterment of patients?
Steve Barclay
My hon. Friend raises an extremely powerful point. It is not only those targets in Wales that are being missed. She will know that people are almost twice as likely to be waiting for treatment in the Labour-run Welsh NHS than they are in England: 21.3% in Wales compared with 12.8% in England. She will also know that the number of two-year waits for operations in Wales, at over 50,000, is considerably higher than that in England, which is below 2,000.
Helen Morgan (North Shropshire) (LD)
On 30 January, the Secretary of State agreed to meet me and my colleagues who represent the other parts of Shropshire to discuss the particularly acute issues that we have been seeing at our hospitals. That meeting is not in the diary. Will he commit to arranging that as soon as possible, so that we can get these issues addressed?
Steve Barclay
I apologise to the hon. Lady because she raises a perfectly fair point. I will do all I can to expedite that meeting.
Marsha De Cordova (Battersea) (Lab)
Robert Courts (Witney) (Con)
The Secretary of State for Health and Social Care (Steve Barclay)
Since March 2019, GPs have recruited over 25,000 staff such as pharmacists, physiotherapists and mental health practitioners, and we are on track to hit our 26,000 additional staff commitment.
Dr Mullan
As a doctor myself, I will be very happy to see one of those many fantastic professionals the Secretary of State mentioned, including pharmacists and physios, in the primary care setting, but I understand from local GPs that patients do not always have the confidence to do that and 111 is not necessarily directing people to see the wider team. Can we ensure 111 is set up to direct people to different professionals, and can we do something to promote and educate the public on how fantastic that wider healthcare team is in primary care?
Steve Barclay
My hon. Friend is absolutely right, which is why I commissioned through NHS England a review of 111. It was initially designed for a different purpose. That allows the GP service to be the front door it has become in the NHS. Through the chief executive of Milton Keynes University Hospital, we have done significant work on the NHS app, so it can better enable patients to get to the right place for the care they need.
Layla Moran
In January, over 45,000 people in Oxfordshire waited more than two weeks to see their GP and 12,000 waited over a month. The top reason given when I visited surgeries was that they simply cannot recruit the doctors they need. For example, Kennington health centre has been forced to close part time because it cannot find a replacement for a retiring partner. That is clearly unsustainable. Will the Secretary of State consider introducing a weighting for GPs in areas of high cost of living outside London? Will he meet me to discuss the specific issues in Oxfordshire?
Steve Barclay
The hon. Member is right to highlight the pressure on primary care, which is why, in the answer I gave a moment ago, I said it is also about looking at the wider skills mix within primary care. She mentions doctors specifically. We have 2,200 more doctors in general practice than before the pandemic. It is about having the right skills mix alongside the doctors to meet the significant increased demand since the pandemic.
Robert Courts
Demand for GP appointments in Oxfordshire is indeed acute. It is driven in part by the need to continue to treat people with long-term medical conditions. Will my right hon. Friend consider what can be done to rebalance the system, so that instead of dealing with people when they present with acute symptoms, more is done to ensure people can be treated at the primary and community level?
Steve Barclay
My hon. Friend highlights an absolutely brilliant point, one I am extremely seized of, which is: how do we get detection much sooner, looking at genomics, screening and identifying issues before the patient is even necessarily aware that they have a condition. Early care delivers far better patient outcomes but it is also far cheaper to deliver. That prevention, as he highlights, is extremely important.
Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)
The primary care crisis in Plymouth is getting worse, but there is a cross-party solution in Plymouth, which is to build a new super health hub, the Cavell centre, in the city centre. The Government have withdrawn the £41 million funding for that, but the Minister’s predecessor offered to put pressure on Devon’s integrated care board to see what could be funded locally and whether there is a national-local partnership that could deliver this pioneering pilot project, which could really improve healthcare in Plymouth that would be a model for the rest of the country. Will the Secretary of State look at Devon’s ICB and whether he could put pressure on that ICB to fund that pioneering project?
Steve Barclay
The hon. Gentleman reasonably highlights that the commissioning is a decision for the ICB, but also rightly draws attention to the opportunity to look at different models, for example, how we look across communities at economies of scale, and how we combine that with modern methods of construction to deliver projects far more quickly. I am happy to look, with Devon ICB, at the issue he raises.
Theresa Villiers (Chipping Barnet) (Con)
I really welcome the increase in patient care staff in GP practices in my constituency, but can I appeal to the Secretary of State to fix the problem with the taxation of GPs’ pensions, which is forcing many into early retirement just when we need their services the most?
Steve Barclay
My right hon. Friend is a very experienced parliamentarian and will know that issues of tax are a matter for my right hon. Friend the Chancellor, but I draw her attention to “Our plan for patients”, which sets out a package of NHS pension scheme measures.
Rachael Maskell (York Central) (Lab/Co-op)
NHS dentists form a really important part of the primary care workforce. However, in places such as York, we have a complete desert, where my constituents just cannot receive NHS dentistry. What is the Secretary of State going to do for my constituents, so that their oral health needs are addressed?
Steve Barclay
We will set out to the House in due course a recovery plan to deal in particular with primary care but also dentistry. We recognise that, notwithstanding the fiscal support that was offered to protect dentistry through the pandemic, it is an area of acute interest across the House. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), will be saying more on that very shortly.
Angela Crawley (Lanark and Hamilton East) (SNP)
Tonia Antoniazzi (Gower) (Lab)
The Secretary of State for Health and Social Care (Steve Barclay)
On Friday I was proud to announce the winners of the third round of the artificial intelligence in health and care award. Winners included projects within the NHS that identify women at risk of stillbirth, help with neurological conditions, find lung blockages and assess the quality of transplant organs, as well as a number of projects focused on cancer, identifying people’s predisposition and its presence. Since its inception in 2019, the AI in health and care award has invested more than £123 million in 86 promising projects, supporting more than 300,000 patients. AI will come to save countless lives in the NHS in the years to come, and that begins with the investment today.
Tonia Antoniazzi
The Secretary of State should know that I am the co-chair of the all-party parliamentary group for access to medical cannabis under prescription, for children with intractable epilepsy. The situation is as intolerable as ever. Both product supply and cost are causing families great pain, and their children are desperate. I urge the Secretary of State to meet me to discuss convening a roundtable to help identify solutions to the crisis of lack of access. I am still awaiting a response from his Minister from 18 January 2023.
Steve Barclay
I am very aware of the hon. Lady’s work as chair of the APPG, so I am not surprised that she asks about that important issue, which she has been assiduous in raising. I will flag up the follow-up with my ministerial colleague. I draw the hon. Lady’s attention to the fact that the National Institute for Health and Care Research remains open to research proposals in this area. I encourage her to ensure through her work on the APPG that bids are made to generate the evidence that the clinicians who make decisions on prescribing need.
Sarah Atherton (Wrexham) (Con)
Steve Barclay
We are always happy to assist colleagues across the United Kingdom as part of our commitment to the Union. My hon. Friend is right to highlight current performance in Wales. As I have said, patients are waiting twice as long for hospital treatment in Wales as in England, and more than 50,000 people in Wales are waiting for more than two years for their operation.
Wes Streeting (Ilford North) (Lab)
When nurses and paramedics voted to take strike action, the Secretary of State refused to negotiate and said that the pay review body’s decision was final. He has now U-turned, but not before 144,000 operations and appointments were cancelled through his incompetence. Will he now apologise to patients for this avoidable disruption?
Steve Barclay
What the hon. Gentleman omits to remind the House is that at the time the demand from trade unions was for a 19% consolidated pay rise, which is very different from the basis on which talks have been entered into. The point is that we are in discussions with trade union colleagues. Trade unions and the Government have a shared purpose—to address the very real challenges that we recognise the NHS workforce have faced, particularly in the context of the pandemic—and a shared desire, which is to focus on patients and ensure that they get the right care to support them.
Wes Streeting
I think patients know who to trust, and it is nurses, not the Secretary of State. The Government have still learned nothing: despite a 98% vote in favour of strikes, the Secretary of State was sent to meet junior doctors without a mandate from the Prime Minister to negotiate. What is the point of this Health Secretary if he is in office but not in charge?
Steve Barclay
I have come to the House literally from a meeting with the trade unions: I met the NHS Staff Council this morning. Once again, hon. Members on the Opposition Front Bench are writing their questions before they see what is actually happening.
Lee Anderson (Ashfield) (Con)
John Penrose (Weston-super-Mare) (Con)
Steve Barclay
As we heard earlier from the Parliamentary Under-Secretary of State, my hon. Friend the Member for Harborough (Neil O’Brien), the major conditions strategy report will deal with those issues. However, it is also important to consider the variation in performance between integrated care boards and how we can raise the bottom quartile to the level of the top quartile—there is far too much variation within the NHS—and to be data-driven, so that when it comes to genomics and screening we can target the outliers more precisely. That is what is behind the issue to which my hon. Friend has rightly drawn attention.
Mr Gregory Campbell (East Londonderry) (DUP)
Sir David Evennett (Bexleyheath and Crayford) (Con)
I welcome the Government’s actions to deal with obesity, but it remains an increasing health issue for our nation. Does my right hon. Friend agree that educating children and parents about healthy eating should be a top priority—
Sir David Evennett
—and may I urge his Department to increase its campaigns on the consequences of obesity?
Steve Barclay
My right hon. Friend’s question was so good that I was eager to answer it early. He is right to highlight this issue, which is being dealt with as part of a wider thrust within Government work on prevention, which is how we can empower the patient. That means getting more data to patients and using genomics and screening to ensure that they are better informed and can therefore opt to take decisions on healthy eating, rather than the state trying to impose those decisions on them in a top-down manner.
Judith Cummins (Bradford South) (Lab)
Steve Barclay
I am happy for a member of the ministerial team to meet the hon. Lady, who has made a compelling case about the return on investment. We will obviously need to scrutinise it in more detail, and I am sure that my colleagues will look forward to doing so.
Rehman Chishti (Gillingham and Rainham) (Con)
The Secretary of State is aware of Medway’s case for being part of the Government’s hospital building programme. It was the hardest-hit area during covid-19, and it has some of the greatest health inequalities in the country, and one of the busiest accident and emergency units in Kent. Will the Secretary of State visit Medway with me to witness our urgent need, so that we can be part of that hospital building programme for the future?
Steve Barclay
My hon. Friend is right to highlight the issues in Medway and those in Kent as a whole. When I met the chief executive of Maidstone Hospital yesterday, we discussed some of the innovation that it has introduced and the benefits of that innovation across the board. As for the new hospitals programme, I remind my hon. Friend of the comments made by my right hon. Friend the Prime Minister on 22 February, when he confirmed the Government’s commitment to that programme.
Jeff Smith (Manchester, Withington) (Lab)
Richard Fuller (North East Bedfordshire) (Con)
Over the past year or so, Bedfordshire’s fire service and ambulance service have taken innovative steps to co-operate to bring response times down. They are now working on a plan to deepen that co-operation. Will my right hon. Friend facilitate a meeting with the leaders of the fire service and ambulance service in due course when that plan is ready?
Steve Barclay
My hon. Friend is right to highlight the community services that we are doing as part of our urgent and emergency recovery plan, looking at how we deliver care quicker through innovative models. One of those involves better co-operation with the fire service.
Samantha Dixon (City of Chester) (Lab)
Sir Christopher Chope (Christchurch) (Con)
Does my right hon. Friend accept that about one third of the activity that takes place in GP surgeries could be transferred to pharmacies? What is he doing to promote that policy and deal with the British Medical Association’s reluctance to co-operate?
Steve Barclay
My hon. Friend is right to highlight the fact that a number of services that GPs currently offer could be performed by pharmacists, and we are looking at that in the context of the primary care recovery plan. This is also about looking at how we can relieve some of the workload pressure within primary care, and that is why we have recruited 25,000 additional staff to support GPs. It is also why we have over 2,000 more doctors in primary care.
Ian Byrne (Liverpool, West Derby) (Lab)
Selaine Saxby (North Devon) (Con)
Does my right hon. Friend agree that community-based drop-in mental health services such as the Link centres in North Devon are vital to remote rural communities? Will he urge Devon County Council not only to continue those services but to improve and extend the model?
Steve Barclay
It is for schemes such as those that my hon. Friend highlights that we are investing a further £2.3 billion a year in mental health services, and that in turn is facilitating an extra 2 million patients accessing NHS-funded mental health support.
Daisy Cooper (St Albans) (LD)
More than £300 million of the NHS dentistry budget is set to be clawed back by NHS England at the end of this month. That is not because of a lack of demand; it is because the Government’s NHS dental contract is broken and dentists are walking away from NHS work. Will the Government ringfence these funds, rolled over to next year, so that people who desperately need dental treatment can get those appointments?
Peter Gibson (Darlington) (Con)
I refer the House to my entry in the Register of Members’ Financial Interests, including my co-chairing of the all-party parliamentary group for hospice and end of life care. Now that integrated care boards have a duty to commission palliative care, what steps is my right hon. Friend taking to assess delivery? Will he join me in calling for the North East and North Cumbria ICB to listen to the hospices in the Tees Valley, which would save our hospices and save the NHS money?
Steve Barclay
My hon. Friend is right to draw the House’s attention to the extremely important work of hospices and to the fact that commissioning decisions are devolved to the integrated care boards so that they can target funding in the way that best serves local communities. He is quite right to lobby on their behalf and I am sure that his relevant ICB will take note of that.
Mr Speaker
Before we come to the statement on the Illegal Migration Bill, I wish to make a brief statement.
I am aware that there are a number of cases before the courts that relate to the subject matter of the Bill. Given the national importance of the issues to be discussed, I am prepared to exercise a waiver and allow brief references to those cases. However, I would ask Members to exercise caution and not to refer in detail to issues that are being considered by the courts.